So obviously there is a correlation between pub sales and alcohol volume sales, but we can't infer anything directly about changes in alcohol volume sales.

This is total turnover (I think), so includes food and other sales, not just alcohol. LFL is basically adjusting for changes in the composition of what people are buying. E.g. if sales were 30% food, 70% alcohol in 2024, but 40%/60% in 2025, the LFL comparison adjusts for this difference.

Is it not just that 'life-changing experience' is being interpreted as something quite specific and revelatory, rather than in a literal way? (sorry to be a dullard)

Also, big props to the authors for putting together an actually useful graphical abstract.

...but it does highlight that there are potential negative impacts of structuring these payments as relatively large lump sums pad to everyone at the same time. Staggered and/or more gradual payments might help avoid these increases in overdose deaths.

This isn't a new phenomenon, other studies have observed this 'check effect', where a lump sum payment can lead to a rise in drug-related harms. The authors of this new study are very (appropriately) careful to emphasise that this doesn't mean these payments were a bad idea...

By coincidence, I updated this graph this afternoon. Interesting quite how in sync the rises and falls in Scotland and the US (and to a much lesser extent NI) are, in spite of very different causes.

That's entirely fair, and those people can get straight in the bin.

The lot of a health economist is just to also be endlessly frustrated by people going 'drug x works, so why doesn't the NHS fund it' without any consideration of either the direct, or opportunity costs of doing so.

I don't have any specific knowledge about the cost-effectiveness of GLP-1s, but I'm certainly open to either possibility being true at this stage.

Also remember, every £ the NHS spends on one treatment is a £ they aren't spending on something else.

Health economist here: just because drugs are expensive or need to be taken for a long time doesn't mean they can't be cost-effective (because they have big health impacts or avert future costs and harms), but similarly, just because drugs are effective, doesn't mean they are necessarily worth it.

Features this really interesting breakdown (IMO) of how reductions in alcohol-related deaths are made up of different causes.

Biggest impacts are for alcohol-related liver disease and dependence-related conditions, but with substantial reductions in chronic disease, especially cancer, longer-term

That certainly seems to be the experience of Scotland, who saw very little impact when they lowered their drink drive limit in 2014, which researchers attributed to a lack of enforcement.

evidence.nihr.ac.uk/alert/a-lowe...

Maybe we could even do both - lower the limit *and* enforce it?

So while I think that the argument for lowering the drink drive limit is pretty overwhelming from both a data and a moral standpoint, I'm sceptical that it will make that much of a difference unless we actually make enforcing that limit a priority.

I'm no policing expert, but I'd imagine this reflects a deprioritisation of drink drive offences compared to other types of crime in the face of funding and resource cuts (happy to be corrected here though). Which would suggest that this is just not something we consider a priority.

You might argue that this is because the problem is going away, but that's not what the data shows. The number of drink drive fatalities, or people killed or seriously injured in drink drive crashes isn't falling. If anything, it's rising (www.gov.uk/government/s...)

But beyond this, we aren't using the limited powers that we do have to address drink driving. The number of breath tests conducted in England & Wales has more than halved since its peak in 2009 (www.gov.uk/government/s...).

Random breath testing is endorsed by the World Health Organization as one of the key policy approaches to tackle drink driving (www.who.int/initiatives/...).

Studies consistently show that it is the perception of the likelihood of being caught that deters potential drink drivers from getting behind the wheel (e.g. doi.org/10.1016/j.aa...). Enforcement of drink driving laws in the UK is limited by a lack of powers for police to conduct random breath tests